by Karen Apwah | Feb 13, 2024 | Electronic Prior Authorization, Prior Authorization
In response to escalating concerns voiced by providers and patients regarding delayed and denied care, an increasing number of states are taking decisive steps to impose limitations on prior authorization (PA) requirements. These legislative efforts, reaching beyond...
by Karen Apwah | Jan 31, 2024 | CMS, Electronic Prior Authorization, Healthcare Technology, Prior Authorization
The healthcare landscape is undergoing a transformative shift with the introduction of the Centers for Medicare & Medicaid Services (CMS) Interoperability and Prior Authorization Final Rule (CMS-0057-F). This comprehensive regulation sets forth a series of...
by Karen Apwah | Jan 29, 2024 | Healthcare Technology, Prior Authorization
The Biden-Harris Administration’s recent announcement on promoting competition in healthcare includes a significant focus on increasing transparency in the Medicare Advantage (MA) insurance market. The U.S. Department of Health and Human Services (HHS) and the...
by Karen Apwah | Jan 4, 2024 | Healthcare Technology, HITRUST & Security
Ensuring the security and confidentiality of patient data is paramount. Healthcare vendors play a crucial role in maintaining the integrity of sensitive information. One key aspect that highlights a commitment to robust security practices is achieving HITRUST...
by Karen Apwah | Dec 8, 2023 | Electronic Prior Authorization, Healthcare Technology, Prior Authorization
Per a recent article posted by MedPage Today, researchers revealed that “ChatGPT provided incorrect or incomplete information when asked about drugs, and in some cases invented references to support its answers, two evaluative studies found. In the first, 39...
by Karen Apwah | Dec 4, 2023 | Adherence, Opioid Overutilization
Addressing the opioid epidemic requires more than just awareness—it demands strategic and efficient solutions. Health Plans and PBMs play a crucial role in curbing this crisis, and Agadia’s RxSentinel+ is at the forefront, empowering organizations to configure...
by Karen Apwah | Nov 21, 2023 | Electronic Prior Authorization, Healthcare Technology, Prior Authorization
In response to the recent report from the Medical Group Management Association (MGMA), it’s evident that the prior authorization process remains a significant challenge for medical groups, impacting patient care and straining operational efficiency. The report...
by Karen Apwah | Nov 15, 2023 | Electronic Prior Authorization, ePrescribing, Prior Authorization
Efficiently processing medical prior authorizations is crucial for Health Plans and Pharmacy Benefit Managers (PBMs) seeking to enhance operational efficiency and improve patient outcomes. In this blog post, we’ll explore the importance of streamlined eMPA...
by Karen Apwah | Nov 7, 2023 | Electronic Prior Authorization, Healthcare Technology, Prior Authorization
As per an article published last Friday, House Democrats are pressuring the Centers for Medicare & Medicaid Services (CMS) to better evaluate how artificial intelligence is utilized by Medicare Advantage (MA) plans, hoping to prevent eye-catching rates of denial....
by Karen Apwah | Nov 6, 2023 | Grievance Management
Agadia is delighted to introduce GrievancesHub – a cutting-edge web-based resolution system engineered to redefine Grievance Management for Health Plans and Pharmacy Benefit Managers (PBMs). Live demos will begin this December. We invite you to schedule a demo...
